Physiotherapy and surgery often go hand in hand, but the story is changing as new evidence evolves. Physiotherapy involves non-invasive methods of treating injuries or pain such as corrective exercise, manual therapies like joint mobilizations or massage techniques, and education around pain or injuries
Orthopedic surgery has been used for decades to treat pain and injuries. Common surgeries performed include Disc decompression surgery, meniscus removal, ligament repair, knee or hip replacements, and tendon repairs. While Physiotherapy is always recommended as the first line of treatment before surgery, there is growing research that supports it being the main treatment instead of surgery.
What does the research say?
It was previously thought that things like disc herniations, ligament and tendon tears, and osteoarthritis could not heal themselves, and would need surgery to be repaired, however, we now know that is not true and that it is a case by case basis. Currently, Physiotherapy has been shown to be just as effective as surgery for the following:
- ACL reconstruction
- Partial removal of a damaged meniscus
- Rotator cuff tendon repair and subacromial decompression surgery
- Lumbar spine fusion
- Disc decompression from a disc herniation
What about Imaging?
A growing body of research studies shows that findings on imaging are not directly correlated to pain or other symptoms. That is to say that your x-ray, MRI, or ultrasound results are not the best predictor of whether or not your pain can be improved or needs surgery. The best predictor of that is your symptoms and your ability to manage your daily life and your pain levels. This is where physiotherapy can help!
The Caveat
After surgery, the vast majority of patients will require physiotherapy to help them rehabilitate back to a level where they can function independently, go to work, play sports, or get back to hobbies. Because physiotherapy is so important, it should be trialed before surgical considerations in an attempt to avoid surgery.
In summary, while some conditions may respond better to surgery, a course of physiotherapy is always going to be useful in the long run.
Book in today for Physiotherapy At For Health’s Sake to get started!
References
van de Graaf VA, Noorduyn JCA, Willigenburg NW, et al. Effect of Early Surgery vs Physical Therapy on Knee Function Among Patients With Nonobstructive Meniscal Tears: The ESCAPE Randomized Clinical Trial. JAMA. 2018;320(13):1328–1337. doi:10.1001/jama.2018.13308
van de Graaf VA, Noorduyn JCA, Willigenburg NW, et al. Effect of Early Surgery vs Physical Therapy on Knee Function Among Patients With Nonobstructive Meniscal Tears: The ESCAPE Randomized Clinical Trial. JAMA. 2018;320(13):1328–1337. doi:10.1001/jama.2018.13308
Bloom A. Donovan, R., Beswick, A.Whitehouse, M., Kunustor S (2021). Common elective orthopedic procedures and their clinical effectiveness: umbrella review of level 1 evidence: BMJ 374: n1511
By: Elias Peixoto